Coping With Advanced Melanoma and a Second Cancer Diagnosis: A Survivor’s Perspective

June 22, 2023
Bryant Wieneke

Bryant Wieneke is a melanoma survivor living in Santa Barbara, California, with his wife, Elvira, and their 2 corgis, Olive and Duckie. He was a university administrator for 30 years and has written 15 books, including Melanoma Without a Cause. You can follow Bryant on his website.

“Go live your life!”

That was the advice of the melanoma expert I had been seeing at the conclusion of my immunotherapy treatments in October 2018. Diagnosed with metastatic melanoma in May 2016, I had received several combination infusions of the immunotherapy drugs nivolumab (Opdivo) and ipilimumab (Yervoy), followed by regular infusions with nivolumab for 2 years. Now, in 2018, I was officially off treatment and cancer-free.

I was monitored with a full-body positron emission tomography and computed tomography (PET-CT) scan every 3 months following treatment. Because the melanoma had spread to my lymph nodes and most organs in my body, including my kidney, liver, lungs, and pancreas, my oncologist wanted to look at everything. I also had a brain magnetic resonance imaging (MRI) scan because a melanoma spot had been removed from the back of my brain.

After completing treatment, my wife Elvira and I proceeded to follow the good doctor’s advice. We went ahead and lived our lives. We were retired, so going to work was out of the question. We played golf and went bike riding. We took long walks at the beach with our 2 corgis, Olive and Duckie. And we were mindful of our good fortune and thankful for every day that we had together. Our life was not trouble free—no life is—and Elvira kept beating me at golf, but all in all, we were doing very well.

At least, we were doing well for 4 and a half years.

My insurance company had long ago stopped approving PET scans for me, but I was still monitored with CT scans and MRIs. However, it was not these tests that pointed to something amiss in 2022. Rather, my new dermatologist wanted to learn more about a lump on my back that had been there for years. He ordered a biopsy that came back positive. This time, it came back as basal cell carcinoma, a different kind of skin cancer, and an excellent surgeon removed all of it.

Once again, it felt as if we had dodged a bullet. However, something had changed for me with this diagnosis. The cancer had been removed, but I felt vulnerable now, as if my freedom from this destructive and deadly disease had been taken away. It didn’t make sense to me, but I had panic attacks and persistent anxiety that didn’t match my physical condition. I was fine in my body but not in my mind.

Coping with the effects of a second cancer diagnosis

Elvira and I took the same approach to this second cancer diagnosis as we did with my original cancer diagnosis: we made a plan and encouraged each other with hope and, as much as possible, a sense of humor. We found that as long as we had a plan, we could focus on the steps to get better, which gave us hope and a light in the distance to move toward, one step at a time. The plan involved getting acupuncture, which had been instrumental in my body’s recovery in 2016. This time, the acupuncture treatment was more for my emotional healing than for treating a physical condition, but after my experiences with cancer, I believe that the 2 are integrally connected.

Things eventually got better. Elvira and I went back to our golfing and bike riding, our long walks with the dogs, and the appreciation of our life together. It was only a few months later, however, that I

found another lump. This time, it was on my ankle. I went through the required hoops, and ultimately, my oncologist decided upon an excisional biopsy in which the surgeon would take a sample of the tissue for the lab and might or might not remove the tumor at the same time.

Soon after I awoke from the surgery, the surgeon appeared at my bedside. He wanted me to know 2 important facts: 1) the lump was indeed metastatic melanoma, and 2) he had removed all of it. Shortly afterward, I was able to get a PET scan approved from my insurance company, and the scan proved negative. The surgeon was right: he had removed it all.

Today, I am cancer-free again, but—and this is a big “but”—I have now had 2 cases of metastatic melanoma. I might be susceptible to getting it again. And where does the basal cell carcinoma fit in with all this? I realize it’s a different kind of cancer, but is there a connection? Maybe. In the broader scheme of things, however, that doesn’t matter. The important point is what happens now.

Last month, I began a new regimen of immunotherapy to prevent the cancer from coming back. It is not the combination treatment, because no cancer currently registers on the scans, but is instead the much easier to tolerate nivolumab. I am also being monitored with regular full-body PET-CT scans and MRIs of my brain to detect any sign of cancer.

I am in good hands with my oncologist and the other doctors at my treatment center in Santa Barbara. It’s beautiful here, my acupuncturist is helping me manage my stress and anxiety, and my wife continues to make me laugh.

In my ears, I can hear my doctor once again saying, “Go live your life!”

You bet I will!

The author has no relationships relevant to this content to disclose.


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